Glucose and lipid metabolic aberrations in preterm and low birth weight infants: Associations with lifestyle-related diseases.

The concept of the developmental origins of health and disease is well established. Prenatal undernutrition, resulting from a mismatch between pre- and postnatal environments, leads to permanent changes in body composition, function, and metabolism. These changes contribute to the development of lifestyle-related diseases such as type 2 diabetes mellitus and hyperlipidemia later in life. The future risk of lifestyle-related diseases in preterm and low-birth-weight infants is closely related to a thrifty phenotype. This phenotype is characterized by an advantageous ability to survive in a low-energy environment, resulting in reduced growth potential and muscle mass. Small size and low muscle mass lead to a decrease in basal metabolism, making it easier to accumulate excess energy as body fat. This differs fundamentally from the typical clinical presentation of obesity, which occurs in a state of energy excess. Our research focuses on two main areas: (1) investigating the increase in insulin resistance due to growth patterns and persistent reduction in lean body mass in preterm and low-birth-weight infants, and (2) studying the development of subcutaneous adipose tissue during the neonatal and infant periods, along with its associated metabolic and hormonal factors. In this review, we provide detailed insights into the mechanism by which sustained decrease in lean body mass and the development of lipid/fatty acid metabolism and adipose tissue during the fetal and neonatal periods may impact the onset of lifestyle-related diseases later in life.